Jim Padovano was immediately drawn to the operating room when he got a chance as a young man to watch open-heart surgery.
“I was just knocked out by the atmosphere and the camaraderie,” he said.
The experience spurred him to become a surgical technician and, after a few years’ experience and some additional training, a surgical assistant. He doesn’t regret the decision.
“You come to work every day and strap on your gloves and try to take care of patients,” said Padovano, 61, who works at an outpatient facility in suburban Milwaukee. “It’s fairly rewarding work.”
It’s also an example of a health care job that doesn’t require a four-year degree but pays a good wage: Surgical assistants can make $50,000 to $70,000 a year.
An estimated 7.4 million of the 12.1 million people who work in health care don’t have four-year degrees _ and many of them work in jobs that pay a middle-class wage, according to a recent report from the Brookings Institution, a policy research organization in Washington.
They include radiology technicians, lab technicians, physical therapy assistants and more than one-third of nurses.
As in the broader economy, wages still are tied to education and skills, even when a job doesn’t require a four-year degree. The best-paying jobs among those without four-year degrees require a two-year degree and other training. And many of the jobs, such as home health aides and certified nursing assistants, pay low wages.
For example, the median income in the Milwaukee metro area for a home health aide is $25,000, according to the Brookings report, and $21,900 for a personal care aide.
The lowest-paying jobs _ as in the overall economy _ also are growing the fastest and employ the most part-time workers.
But more than in most fields, health care often offers a clear pathway to a higher-paying career for people who get additional training and education, said Martha Ross, a fellow at the Brookings Metropolitan Policy Program and a co-author of the report.
A much-cited example is the licensed practical nurse or medical assistant who earns first a two-year and then a four-year degree in nursing _ and then goes on to earn a master’s degree.
UPWARD MOBILITY
Examples, though, can be found throughout health care.
Anita Jefferson, 34, started at a front desk at a hospital and now works as a physical therapy assistant, focusing on transplant patients, helping them regain their mobility and strength.
The job required her to earn a two-year degree at Milwaukee Area Technical College. That took some patience _ she waited two and a half years to get into the program. And though tuition reimbursement helped with some of the cost, Jefferson acknowledged that going to school while working wasn’t easy.
“But it was something I wanted to do,” she said.
Jefferson, who graduated in 2009, said many people don’t know about the good jobs in health care that don’t require a four-year degree.
“I love it _ it’s rewarding,” she said. “I’m able to help patients regain something they could do before.”
Unlike the broader economy, the number of jobs in health care has increased at a fast pace, reflecting the sharp increase in health care as a share of the overall economy.
The Brookings report focused on the 10 occupations in health care that account for about 85 percent of the workers without four-year degrees in the 100 largest metropolitan areas.
It found that the number of jobs in those occupations increased by 46 percent from the year 2000 to a period encompassing 2009-‘11. That contrasts with an increase of 3 percent among workers without four-year degrees across all occupations in all industries over the same time period.
The increase in health care jobs hasn’t sheltered less-skilled workers from the broader trends in the economy.
After adjusting for inflation, only registered nurses saw their real earnings increase from 2000 to 2009-‘11, according to the Brookings report. Their earnings grew an estimated 6 percent nationally.
In the Milwaukee metro area, where registered nurses earn a median income of $60,000, the increase was higher at 11.1 percent.
A higher percentage of registered nurses in the Milwaukee area have four-year degrees, according to the report. And though health systems in the area still sometimes hire nurses with two-year degrees, they generally are expected to work toward earning a bachelor’s in nursing.
Nursing aides, medical assistants and personal care aides, in contrast, saw their wages decline after adjusting for inflation. For example, nursing aides were making on average 11 percent _ or $2,900 _ less a year in 2009-‘11 than they were making in 2000.
“It’s a good news/bad news story in terms of helping people without college degrees earn good wages,” said Ross, of Brookings.
The drops in real wages, though, were lower than the estimated 14 percent decline _ about $5,500 a year _ for all workers without a four-year degree during the same period, according to the report.
UNEVEN OPPORTUNITIES
The opportunities for advancement in health care also vary based on the job and employer, and the report notes that career ladders do not always work in practice.
Many workers with low levels of education have limited literacy and math skills as well as family responsibilities, the report said, and both make it difficult to complete additional education and training.
“It always depends on where you are starting from and the nature of your employer,” Ross said.
A number of health care systems offer a program to prepare people for returning to school or moving to new positions.
Employees attend classes _ while getting paid _ for several hours a week for eight months to sharpen their computer, math and other skills. Each candidate also is assigned to a human resources consultant as an adviser.
“The impact has been tremendous,” said Susan Sanson, executive director of educational services at a Milwaukee-area hospital.
Another health care group will train employees at times to be pharmacy technicians, medical assistants, radiology technicians, phlebotomists and other health care occupations.
Todd Cowell, a radiation technician, got his training while working at a VA medical center.
“After the first couple of months, I knew it was the right decision for me,” Cowell said.
A radiology technician can make more than $50,000 a year in the Milwaukee area.
“A lot of people these days are told you need a four-year degree,” Cowell said. “That’s all you hear, which isn’t true.”
MORE IS STILL BETTER
But you do need training, and many jobs that once required two-year degrees increasingly are requiring four-year degrees.
The majority of people who work in good-paying jobs once open to people with two-year degrees _ such as nursing, radiology technicians and clinical lab technicians _ have four-year degrees.
Personal care aides and home health care aides and others also face challenges in advancing, Ross said.
Home health aides work apart from other people on a health care team, she noted, and are not exposed to people who can be mentors and role models. That can be a strong influence.
Health care is a workplace in which people of different incomes and education levels work together, providing potential role models for low-paid workers.
A licensed practical nurse comes to realize that he or she could be a registered nurse, for instance, or a surgical technician realizes that he or she could become a surgical assistant.
The career path is clear _ and people know that with additional schooling and training they stand a good chance of making a better living.
That, though, is just part of the potential rewards.
Padovano, the surgical assistant, and others are quick to mention the satisfaction that the work can bring.
“You just know you have had a good day,” he said. “You did some good things. You helped some people.”
